1
|
Carrillo I, Serpa P, Landa-Ramírez E, Guilabert M, Gómez-Ayala Y, López-Pineda A, Mira JJ. Speaking Up About Patient Safety, Withholding Voice and Safety Climate in Clinical Settings: a Cross-Sectional Study Among Ibero-American Healthcare Students. Int J Public Health 2024; 69:1607406. [PMID: 39011389 PMCID: PMC11246871 DOI: 10.3389/ijph.2024.1607406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 06/17/2024] [Indexed: 07/17/2024] Open
Abstract
Objectives To explore speaking up behaviours, barriers to openly expressing patient safety concerns, and perceived psychological safety climate in the clinical setting in which healthcare trainees from Ibero-America were receiving their practical training. Methods Cross-sectional survey of healthcare trainees from Colombia, Mexico, and Spain (N = 1,152). Before the field study, the Speaking Up About Patient Safety Questionnaire (SUPS-Q) was translated into Spanish and assessed for face validity. A confirmatory factor analysis was conducted to establish the construct validity of the instrument, and the reliability was assessed. The SUPS-Q was used to evaluate voice behaviours and the perceived psychological safety climate among Ibero-American trainees. Descriptive and frequency analyses, tests for contrasting means and proportions, and logistic regression analyses were performed. Results Seven hundred and seventy-one trainees had experience in clinical settings. In the previous month, 88.3% had experienced patient safety concerns, and 68.9% had prevented a colleague from making an error. More than a third had remained silent in a risky situation. Perceiving concerns, being male or nursing student, and higher scores on the encouraging environment scale were associated with speaking up. Conclusion Patient safety concerns were frequent among Ibero-American healthcare trainees and often silenced by personal and cultural barriers. Training in speaking up and fostering safe interprofessional spaces is crucial.
Collapse
Affiliation(s)
- Irene Carrillo
- Department of Health Psychology, Miguel Hernández University of Elche, Elche, Spain
| | - Piedad Serpa
- Department of Clinical Management and Patient Safety, School of Medicine, Universidad de Santander, Bucaramanga, Colombia
| | - Edgar Landa-Ramírez
- Facultad de Psicología, National Autonomous University of Mexico, Mexico City, Mexico
- Programa de Psicología Urgencias, Hospital General Dr. Manuel Gea Gonzalez, Mexico City, Mexico
| | - Mercedes Guilabert
- Department of Health Psychology, Miguel Hernández University of Elche, Elche, Spain
| | - Yesenia Gómez-Ayala
- Facultad de Psicología, National Autonomous University of Mexico, Mexico City, Mexico
| | - Adriana López-Pineda
- Clinical Medicine Department, School of Medicine, Miguel Hernández University of Elche, Elche, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
| | - José Joaquín Mira
- Department of Health Psychology, Miguel Hernández University of Elche, Elche, Spain
- ATENEA Research Group, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Valencia, Spain
- Alicante-Sant Joan Health District, Alicante, Spain
| |
Collapse
|
2
|
Coleman BC, Rubinstein SM, Salsbury SA, Swain M, Brown R, Pohlman KA. The World Federation of Chiropractic Global Patient Safety Task Force: a call to action. Chiropr Man Therap 2024; 32:15. [PMID: 38741191 DOI: 10.1186/s12998-024-00536-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/26/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND The Global Patient Safety Action Plan, an initiative of the World Health Organization (WHO), draws attention to patient safety as being an issue of utmost importance in healthcare. In response, the World Federation of Chiropractic (WFC) has established a Global Patient Safety Task Force to advance a patient safety culture across all facets of the chiropractic profession. This commentary aims to introduce principles and call upon the chiropractic profession to actively engage with the Global Patient Safety Action Plan beginning immediately and over the coming decade. MAIN TEXT This commentary addresses why the chiropractic profession should pay attention to the WHO Global Patient Safety Action Plan, and what actions the chiropractic profession should take to advance these objectives. Each strategic objective identified by WHO serves as a focal point for reflection and action. Objective 1 emphasizes the need to view each clinical interaction as a chance to improve patient safety through learning. Objective 2 urges the implementation of frameworks that dismantle systemic obstacles, minimizing human errors and strengthening patient safety procedures. Objective 3 supports the optimization of clinical process safety. Objective 4 recognizes the need for patient and family engagement. Objective 5 describes the need for integrated patient safety competencies in training programs. Objective 6 explains the need for foundational data infrastructure, ecosystem, and culture. Objective 7 emphasizes that patient safety is optimized when healthcare professionals cultivate synergy and partnerships. CONCLUSIONS The WFC Global Patient Safety Task Force provides a structured framework for aligning essential considerations for patient safety in chiropractic care with WHO strategic objectives. Embracing the prescribed action steps offers a roadmap for the chiropractic profession to nurture an inclusive and dedicated culture, placing patient safety at its core. This commentary advocates for a concerted effort within the chiropractic community to commit to and implement these principles for the collective advancement of patient safety.
Collapse
Affiliation(s)
- Brian C Coleman
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA
- Department of Biostatistics (Health Informatics), Yale School of Public Health, New Haven, CT, USA
- Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Sidney M Rubinstein
- Department of Health Sciences, Faculty of Science, Amsterdam Movement Sciences Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Stacie A Salsbury
- Palmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, IA, USA
| | - Michael Swain
- Department of Chiropractic, Macquarie University, Sydney, Australia
| | | | - Katherine A Pohlman
- Research Center, Parker University, 2540 Walnut Hill Lane, 75229, Dallas, TX, USA.
| |
Collapse
|
3
|
Liu M, Liu L, Lv Z, Ma F, Mao Y, Liu Y. Effects of burnout and work engagement in the relationship between self-efficacy and safety behaviours-A chained mediation modelling analysis. J Adv Nurs 2024; 80:1473-1483. [PMID: 37904573 DOI: 10.1111/jan.15925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/05/2023] [Accepted: 10/18/2023] [Indexed: 11/01/2023]
Abstract
AIMS To explore the current situation, influencing factors and pathways of safety behaviour of nurses in tumour specialized hospitals, in order to provide a theoretical basis for managers to manage and train nurses, improve their safety behaviour level and ensure medical safety. DESIGN An anonymous cross-sectional survey. METHOD A total of 2147 nurses from Grade A cancer hospitals in 15 provinces of China were selected by a convenient sampling method. Questionnaires were collected through the Questionnaire Star platform. Nurses' safety behaviour was measured using the nurse Safety Behaviour Scale, Self-efficacy by the General Self-efficacy Scale, and nurses' occupational burnout was measured by the occupational Burnout Scale, and work engagement through the the Work Engagement Scale. Structural equation modelling was used to test the relationship among nurses' safety behaviour, general self-efficacy, occupational burnout and work engagement. SPSS25.0 software was used to test the relationship among the safety behaviour of nurses, general self-efficacy, occupational burnout and work engagement. RESULTS The total score of safety behaviour of nurses was 55.45 ± 6.879, the total score of general self-efficacy was 31.39 ± 5.729, the total score of occupational burnout was 44.99 ± 26.587, and the total score of work engagement was 38.48 ± 13.433; the scores of the Nurse Safety Behaviour Scale, Self-Efficacy Scale, and Work Engagement Scale were positively correlated (all p < .001); the occupational burnout scale was negatively correlated with the scores of self-efficacy scale, work engagement scale and nurse safety behaviour scale (all p < .001); Structural equation model analysis shows that self-efficacy and work engagement have a direct positive impact on nurse safety behaviour(β = .103, β = .096, all p < .001); Occupational burnout has a direct negative impact on self-efficacy, work engagement and nurse safety behaviour(β = -.371, β = -.413, β = -.328 all p < .001). Bootstrap analysis showed that occupational burnout and job involvement had a significant chain mediating effect between self-efficacy and the safety behaviour of nurses (95% CI: 0.148-0.21). The total effect of self-efficacy on the safety behaviour of nurses was 0.283 (p < .001, 95% CI: 0.225-0.301), the direct effect was 0.096 (p < .001, 95% CI: 0.042-0.15), and the indirect effect was 0.179 (p < .001, 95% CI: 0.085-0.215), The mediating effect accounted for 63.3% of the total effect size. CONCLUSION Occupational burnout and work engagement play a partial mediating role between self-efficacy and nurse safety behaviour. It is necessary to strengthen training on nurse safety culture awareness, improve the nurse self-efficacy and work engagement, reduce nurse occupational burnout, and thereby improve the level of nurses' safety behaviour.
Collapse
Affiliation(s)
- Man Liu
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer (NCRCC), Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Lu Liu
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer (NCRCC), Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zhuoheng Lv
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer (NCRCC), Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Fengyan Ma
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer (NCRCC), Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yousheng Mao
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer (NCRCC), Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yan Liu
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer (NCRCC), Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| |
Collapse
|
4
|
Asadi M, Ahmadi F, Mohammadi E, Vaismoradi M. A grounded theory of the implementation of medical orders by clinical nurses. BMC Nurs 2024; 23:113. [PMID: 38347548 PMCID: PMC10863222 DOI: 10.1186/s12912-024-01775-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 01/29/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVE To explore the process of implementing medical orders by clinical nurses, and identify specific areas of concern in the implementation process, and uncover strategies to address these concerns. BACKGROUND The implementation of medical orders is a crucial responsibility for clinical nurses, as they bear legal accountability for the precise implementation of directives issued by medical practitioners. The accurate implementation of these orders not only shapes the quality and safety of healthcare services but also presents numerous challenges that demand careful consideration. METHOD This study employed a qualitative design using a grounded theory approach to construct a comprehensive theoretical framework grounded in the insights and experiences of nurses operating within the hospital settings of Iran. The study encompassed 20 participants, comprising 16 clinical nurses, two nurse managers, and two specialist doctors working in hospital settings. The selection process involved purposeful and theoretical sampling methods to ensure diverse perspectives. Data collection unfolded through in-depth, individual, semi-structured interviews, persisting until data saturation was achieved. The analytical framework proposed by Corbin and Strauss (2015) guided the process, leading to the development of a coherent theory encapsulating the essence of the study phenomenon. FINDINGS The primary finding of the study underscores the significance of 'legal threat and job prestige' highlighting diverse repercussions in case of errors in the implementation of medical orders. At the core of the investigation, the central variable and the theory of the study was the 'selective and tasteful implementation of orders to avoid legal and organizational accountability.' This indicated a set of strategies employed by the nurses in the implementation of medical orders, encapsulated through three fundamental concepts: 'accuracy in controlling medical orders,' 'untruth documentation,' and 'concealment of events. The formidable influence of legal threats and job prestige was further compounded by factors such as heavy workloads, the doctor's non-compliance with legal instructions for giving verbal orders, the addition of orders by the doctor without informing nurses, and pressure by nursing managers to complete documentation. The resultant psychological distress experienced by nurses not only jeopardized patient safety but also underscored the intricate interplay between legal implications and professional standing within the healthcare framework. CONCLUSION Alleviating staff shortages, enhancing the professional rapport between doctors and nurses, offering legal support to nursing staff, implementing measures such as recording departmental phone conversations to deter the non-acceptance of verbal orders, fostering an organizational culture that embraces nurse fallibility and encourages improvement, and upgrading equipment can ameliorate nurses' apprehensions and contribute to the safe implementation of medical orders.
Collapse
Affiliation(s)
- Monireh Asadi
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, P.O. Box. 14155-4838, Tehran, Iran
| | - Fazlollah Ahmadi
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, P.O. Box. 14155-4838, Tehran, Iran.
| | - Easa Mohammadi
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, P.O. Box. 14155-4838, Tehran, Iran
| | - Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
- Faculty of Science and Health, Charles Sturt University, Orange, NSW, Australia
| |
Collapse
|
5
|
Mistri IU, Badge A, Shahu S. Enhancing Patient Safety Culture in Hospitals. Cureus 2023; 15:e51159. [PMID: 38283419 PMCID: PMC10811440 DOI: 10.7759/cureus.51159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/27/2023] [Indexed: 01/30/2024] Open
Abstract
Patient safety has become a top priority for healthcare organizations. A better patient safety environment is associated with a lower probability of significant complications. Training programmers is critical to promoting patient safety and minimizing misunderstandings. The quality, performance, and productivity of the healthcare industry can be dramatically improved by changing the patient safety atmosphere operating within the hospital sector. Hospitals can significantly reduce medical errors and adverse events by implementing the program and training programmers to prioritize patient safety. This will improve patient outcomes and increase efficiency and effectiveness. Creating a patient safety culture within hospitals will contribute to a higher standard of care and improved overall performance in the healthcare industry. Hospitals can identify systemic problems and implement proactive measures to prevent future incidents by creating an environment in which healthcare professionals feel comfortable reporting errors. A patient safety culture encourages collaboration and open communication among healthcare teams leading to more effective and coordinated care.
Collapse
Affiliation(s)
- Isha U Mistri
- Hospital Administration, School of Allied Health Sciences, Datta Meghe Institute of Higher Education and Research (Deemed to Be University), Nagpur, IND
| | - Ankit Badge
- Microbiology, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to Be University), Nagpur, IND
| | - Shivani Shahu
- Hospital Administration, School of Allied Health Sciences, Datta Meghe Institute of Higher Education and Research (Deemed to Be University), Nagpur, IND
| |
Collapse
|
6
|
Abrahams FR, Daniels ER, Niikondo HN, Amakali K. Students' knowledge, attitude and practices towards pressure ulcer prevention and management. Health SA 2023; 28:2180. [PMID: 36873786 PMCID: PMC9983280 DOI: 10.4102/hsag.v28i0.2180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 11/22/2022] [Indexed: 02/04/2023] Open
Abstract
Background Student nurses provide nursing care to patients during clinical allocation, and their competence may affect the quality of care given to the patients. Good knowledge and positive attitudes enhance early detection for prevention and management of pressure ulcers. Aim To determine undergraduate nursing students' knowledge, attitude and practices (KAP) towards prevention and management of pressure ulcers. Setting A nursing education institution in Windhoek, Namibia. Methods A quantitative, cross-sectional research design was used to conveniently sample (n = 50) student nurses and collect data using a self-administered questionnaire. Data were analysed using the statistical software programme (SPSS) version 27. Descriptive frequencies were applied, and Fishers exact test was performed. A statistical value of p < 0.05 was considered significant. Results Fifty (n = 50) student nurses consented to participate in the study. Student nurses reported good levels of knowledge (n = 35; 70%), attitude (n = 39; 78%), practices (n = 47; 94%). There was no statistically significant association between demographic variables and the level of knowledge, attitudes and practices, p > 0.05. Conclusion Student nurses have good knowledge, positive attitudes and practices on prevention and management of pressure ulcers. By the implications, the study concludes that the nursing students will competently manage the pressure ulcers occurring in the clinical setting. An observational study is recommended to assess practices in the clinical setting. Contribution The findings of this study will help to close the gap in the implementation of standard operating procedures for the prevention and management of pressure ulcers.
Collapse
Affiliation(s)
- Franco R Abrahams
- Department of General Nursing Sciences, Faculty of Health Sciences, School of Nursing, University of Namibia, Windhoek, Namibia
| | - Edwin R Daniels
- Department of Allied Health, Faculty of Health Sciences, School of Nursing, University of Namibia, Windhoek, Namibia
| | - Hileni N Niikondo
- Department of General Nursing Sciences, Faculty of Health Sciences, School of Nursing, University of Namibia, Windhoek, Namibia
| | - Kristofina Amakali
- Department of General Nursing Sciences, Faculty of Health Sciences, School of Nursing, University of Namibia, Windhoek, Namibia
| |
Collapse
|
7
|
Montilla-Herrador J, Lozano-Meca JA, Baño-Alcaraz A, Lillo-Navarro C, Martín-San Agustín R, Gacto-Sánchez M. Knowledge and Attitudes towards Patient Safety among Students in Physical Therapy in Spain: A Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11618. [PMID: 36141888 PMCID: PMC9517046 DOI: 10.3390/ijerph191811618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/30/2022] [Accepted: 09/08/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: Patient safety is a discipline of health care management aiming to prevent and reduce errors and harm to patients. The assessment of knowledge and attitudes on patient safety among students in physical therapy is still scarce; no studies have yet explored the changes that internship periods may produce. Objectives: 1. to determine the attitudes and knowledge of students in physical therapy with respect to patient safety in a Spanish University; and 2. to explore changes following a practical internship period. (2) Methods: Longitudinal study. Data from the Attitudes to Patient Safety Questionnaire III (APSQ-III) before and after the internship period were obtained from an initial sample of 125 students and average positive response rates were compared. (3) Results: "Team functioning", "Importance of patient safety in the curriculum", and "Error inevitability" displayed the highest scores, in accordance with the current literature. After the internship period, the dimensions "Patient safety training received" (p = 0.001), "Error reporting confidence" (p = 0.044), and "Professional incompetence as an error cause" (p = 0.027) showed significant changes. (4) Conclusions: The current study, highlighting areas of strengths and weaknesses in the knowledge and attitudes of students in physical therapy towards patient safety, may be a foundation to adopt tailored programs to enhance students' competencies in patient safety.
Collapse
Affiliation(s)
- Joaquina Montilla-Herrador
- Department of Physical Therapy, Faculty of Medicine, CEIR Campus Mare Nostrum (CMN), University of Murcia, 30100 Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria-Virgen de la Arrixaca (IMIB-Arrixaca), El Palmar, 30120 Murcia, Spain
| | - José A. Lozano-Meca
- Department of Physical Therapy, Faculty of Medicine, CEIR Campus Mare Nostrum (CMN), University of Murcia, 30100 Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria-Virgen de la Arrixaca (IMIB-Arrixaca), El Palmar, 30120 Murcia, Spain
| | - Aitor Baño-Alcaraz
- Department of Physical Therapy, Faculty of Medicine, CEIR Campus Mare Nostrum (CMN), University of Murcia, 30100 Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria-Virgen de la Arrixaca (IMIB-Arrixaca), El Palmar, 30120 Murcia, Spain
| | - Carmen Lillo-Navarro
- Department of Pathology and Surgery and Center for Translational Research in Physical Therapy (CEIT), University Miguel Hernández, Sant Joan, 03202 Alicante, Spain
| | | | - Mariano Gacto-Sánchez
- Department of Physical Therapy, Faculty of Medicine, CEIR Campus Mare Nostrum (CMN), University of Murcia, 30100 Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria-Virgen de la Arrixaca (IMIB-Arrixaca), El Palmar, 30120 Murcia, Spain
| |
Collapse
|